Physician asthma education program improves outcomes for children of low-income families

Randall Brown, Susan L. Bratton, Michael D. Cabana, Niko Kaciroti, Noreen M. Clark

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Study objectives: To determine whether an interactive physician seminar that has been shown to improve patient/parent satisfaction and to decrease emergency department visits for children with asthma was also effective for those children from low-income families. Design: Seventy-four pediatricians and 637 of their patients were randomized to receive two asthma seminars or no educational programs and were observed for 2 years. Setting: Physicians in the New York, NY, and Ann Arbor, MI, areas were enrolled, and, on average, 10 patients with asthma per provider were surveyed and observed for 2 years. Patients or participants: A total of 637 subjects were enrolled, and 369 subjects remained in the study after 2 years. Of these, 279 had complete medical and survey information. Interventions: Physicians were randomized, and then a random sample of their patients was enrolled and surveyed regarding the physician's communication style, the child's asthma symptoms, medical needs, and asthma care. Low income was defined as annual income of < $20,000. Measurements and results: The families of 36 children (13%) had an income of < $20,000, and they were treated by 23 physicians. Low-income children in the treatment group tended to have higher levels of use of controller medications, to receive a written asthma action plan, and to miss fewer days of school, although these differences were not statistically significant compared to low-income children in the control group. However, low-income treatment group children were significantly less likely to be admitted to an emergency department (annual rate, 0.208 vs 1.441, respectively) or to a hospital (annual rate, 0 vs 0.029, respectively) for asthma care compared to children in the control group. Conclusions: The educational program for physicians improved asthma outcomes for their low-income patients. Provider interventions targeted to these high-risk patients may diminish hospital and emergency department asthma care.

Original languageEnglish (US)
Pages (from-to)369-374
Number of pages6
JournalChest
Volume126
Issue number2
DOIs
StatePublished - Aug 2004
Externally publishedYes

Fingerprint

Asthma
Physicians
Education
Hospital Emergency Service
Control Groups
Hospital Departments
Patient Satisfaction
Communication
Therapeutics

Keywords

  • Asthma
  • Communication
  • Controller medications
  • Emergency department
  • Hospitalization
  • Pediatric
  • Physician education

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Physician asthma education program improves outcomes for children of low-income families. / Brown, Randall; Bratton, Susan L.; Cabana, Michael D.; Kaciroti, Niko; Clark, Noreen M.

In: Chest, Vol. 126, No. 2, 08.2004, p. 369-374.

Research output: Contribution to journalArticle

Brown, Randall ; Bratton, Susan L. ; Cabana, Michael D. ; Kaciroti, Niko ; Clark, Noreen M. / Physician asthma education program improves outcomes for children of low-income families. In: Chest. 2004 ; Vol. 126, No. 2. pp. 369-374.
@article{97db98b8bdf948c3962e7bbba871775b,
title = "Physician asthma education program improves outcomes for children of low-income families",
abstract = "Study objectives: To determine whether an interactive physician seminar that has been shown to improve patient/parent satisfaction and to decrease emergency department visits for children with asthma was also effective for those children from low-income families. Design: Seventy-four pediatricians and 637 of their patients were randomized to receive two asthma seminars or no educational programs and were observed for 2 years. Setting: Physicians in the New York, NY, and Ann Arbor, MI, areas were enrolled, and, on average, 10 patients with asthma per provider were surveyed and observed for 2 years. Patients or participants: A total of 637 subjects were enrolled, and 369 subjects remained in the study after 2 years. Of these, 279 had complete medical and survey information. Interventions: Physicians were randomized, and then a random sample of their patients was enrolled and surveyed regarding the physician's communication style, the child's asthma symptoms, medical needs, and asthma care. Low income was defined as annual income of < $20,000. Measurements and results: The families of 36 children (13{\%}) had an income of < $20,000, and they were treated by 23 physicians. Low-income children in the treatment group tended to have higher levels of use of controller medications, to receive a written asthma action plan, and to miss fewer days of school, although these differences were not statistically significant compared to low-income children in the control group. However, low-income treatment group children were significantly less likely to be admitted to an emergency department (annual rate, 0.208 vs 1.441, respectively) or to a hospital (annual rate, 0 vs 0.029, respectively) for asthma care compared to children in the control group. Conclusions: The educational program for physicians improved asthma outcomes for their low-income patients. Provider interventions targeted to these high-risk patients may diminish hospital and emergency department asthma care.",
keywords = "Asthma, Communication, Controller medications, Emergency department, Hospitalization, Pediatric, Physician education",
author = "Randall Brown and Bratton, {Susan L.} and Cabana, {Michael D.} and Niko Kaciroti and Clark, {Noreen M.}",
year = "2004",
month = "8",
doi = "10.1378/chest.126.2.369",
language = "English (US)",
volume = "126",
pages = "369--374",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "2",

}

TY - JOUR

T1 - Physician asthma education program improves outcomes for children of low-income families

AU - Brown, Randall

AU - Bratton, Susan L.

AU - Cabana, Michael D.

AU - Kaciroti, Niko

AU - Clark, Noreen M.

PY - 2004/8

Y1 - 2004/8

N2 - Study objectives: To determine whether an interactive physician seminar that has been shown to improve patient/parent satisfaction and to decrease emergency department visits for children with asthma was also effective for those children from low-income families. Design: Seventy-four pediatricians and 637 of their patients were randomized to receive two asthma seminars or no educational programs and were observed for 2 years. Setting: Physicians in the New York, NY, and Ann Arbor, MI, areas were enrolled, and, on average, 10 patients with asthma per provider were surveyed and observed for 2 years. Patients or participants: A total of 637 subjects were enrolled, and 369 subjects remained in the study after 2 years. Of these, 279 had complete medical and survey information. Interventions: Physicians were randomized, and then a random sample of their patients was enrolled and surveyed regarding the physician's communication style, the child's asthma symptoms, medical needs, and asthma care. Low income was defined as annual income of < $20,000. Measurements and results: The families of 36 children (13%) had an income of < $20,000, and they were treated by 23 physicians. Low-income children in the treatment group tended to have higher levels of use of controller medications, to receive a written asthma action plan, and to miss fewer days of school, although these differences were not statistically significant compared to low-income children in the control group. However, low-income treatment group children were significantly less likely to be admitted to an emergency department (annual rate, 0.208 vs 1.441, respectively) or to a hospital (annual rate, 0 vs 0.029, respectively) for asthma care compared to children in the control group. Conclusions: The educational program for physicians improved asthma outcomes for their low-income patients. Provider interventions targeted to these high-risk patients may diminish hospital and emergency department asthma care.

AB - Study objectives: To determine whether an interactive physician seminar that has been shown to improve patient/parent satisfaction and to decrease emergency department visits for children with asthma was also effective for those children from low-income families. Design: Seventy-four pediatricians and 637 of their patients were randomized to receive two asthma seminars or no educational programs and were observed for 2 years. Setting: Physicians in the New York, NY, and Ann Arbor, MI, areas were enrolled, and, on average, 10 patients with asthma per provider were surveyed and observed for 2 years. Patients or participants: A total of 637 subjects were enrolled, and 369 subjects remained in the study after 2 years. Of these, 279 had complete medical and survey information. Interventions: Physicians were randomized, and then a random sample of their patients was enrolled and surveyed regarding the physician's communication style, the child's asthma symptoms, medical needs, and asthma care. Low income was defined as annual income of < $20,000. Measurements and results: The families of 36 children (13%) had an income of < $20,000, and they were treated by 23 physicians. Low-income children in the treatment group tended to have higher levels of use of controller medications, to receive a written asthma action plan, and to miss fewer days of school, although these differences were not statistically significant compared to low-income children in the control group. However, low-income treatment group children were significantly less likely to be admitted to an emergency department (annual rate, 0.208 vs 1.441, respectively) or to a hospital (annual rate, 0 vs 0.029, respectively) for asthma care compared to children in the control group. Conclusions: The educational program for physicians improved asthma outcomes for their low-income patients. Provider interventions targeted to these high-risk patients may diminish hospital and emergency department asthma care.

KW - Asthma

KW - Communication

KW - Controller medications

KW - Emergency department

KW - Hospitalization

KW - Pediatric

KW - Physician education

UR - http://www.scopus.com/inward/record.url?scp=4143127776&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4143127776&partnerID=8YFLogxK

U2 - 10.1378/chest.126.2.369

DO - 10.1378/chest.126.2.369

M3 - Article

C2 - 15302719

AN - SCOPUS:4143127776

VL - 126

SP - 369

EP - 374

JO - Chest

JF - Chest

SN - 0012-3692

IS - 2

ER -